Author: Dr. William Rassman

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Hair Loss InformationI Don’t Want a Mature Hairline! – Hair Loss Information – Balding Blog

Im 23, and know I have lost hair. My hair used to be really thick, and I have lost hair diffusely, at crown, and temples. 2 Derms I went to said it was simply a mature hairline. I dont want a mature hairline, I will not feel stupid being 30 with a teenage hairline. The derm said that I can try propecia if I want to. My mom and uncle have both mentioned my hair looks thinner. Im unsure what to do.

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There are men that do not ‘grow up’ from a hair line perspective, so you can get reconstructive hair transplant surgery to bring back that old child-like hairline. While it is respectable that you do not want a mature hair line, it is something most hair transplant doctors do not treat, but something that I would be willing to do in a 30 year old who met certain criteria. The criteria would be:

  1. that the predictable hair loss pattern will not be advanced
  2. that your supply of donor hair will be enough to meet your needs on a worst case scenario
  3. that the various elements of your hair characteristics meet my criteria
  4. that you understand what is the worst case scenario for progressive hair loss and have a plan worked out with me to deal with it
  5. that you are mature and of sound mind and body
  6. that you have the finances to follow a worst case scenario through if it happened
  7. that you can tolerate and are willing to take Propecia for the rest of your life

Currently there is no data that shows finasteride (Propecia) will stop the progression to a mature hair line. Propecia can only be prescribed by a medical doctor and it is important to establish a correct diagnosis before you start any medication.

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Hair Loss InformationMaturing Hairline vs Balding – Hair Loss Information – Balding Blog

Hi

I’m 27 and first noticed that my hairline was receding at the temples when I was about 19. It has since been very gradually receding at the temples to the point where I’m now at a 2 on the Norwood Scale.

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What you are telling me sounds like the normal transition from a juvenile hair line to a mature hair line. A Norwood Class 2 pattern is a normal mature male hairline and most men will see a rise in their hairlines and some corner recession between the ages of 19-29. Sounds like you are fitting that pattern of change, not worth obsessing over what may be just a normal maturing process.

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Hair Loss InformationEyelash Loss After Accutane Use – Hair Loss Information – Balding Blog

Dear Dr Rassman

I have had eyelash loss after accutane use. i still lose eyelashes and it has been for over 12 weeks. i contacted several doctors but they do not know what the reason can be. i just used accutane for 2 weeks, but still i have a problems. i still waiting for your feedback. i check my e-mail every day, i hope you can help me whith it.

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Hair loss is a known side effect of Accutane. Unfortunately for you, the hair loss occurs from your eyelashes. Hair loss from Accutane often is reversible if you wait up to a year, but the eyebrow tends to be more sensitive and as such, may not recover. You will still need to wait it out for a year.

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Rejection for Cosmetic Surgery – Hair Loss Information – Balding Blog

Do you ever reject a patient for plastic surgery?

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I have seen a small number of patients who seemed dissatisfied with so many of their features (inappropriately), that I’ve recommended self-evaluation and/or psychotherapy instead of cosmetic surgery. Some of these patient admit to being harshly criticized by a parent during childhood, and may have severe self-esteem issues that will not be addressed by the cosmetic surgery process. It is important for patients to be mentally sound, able to understand what cosmetic surgery will and will not do for you. I try to probe the person behind the request to understand if what I can do will truly meet the objectives of the patient. This is a difficult process for the plastic surgeon because each patient does not undergo an extensive psychological analysis, so I have to trust the instincts I have developed over the years. I do reject patients who do not have realistic expectations or those who are psychologically imbalanced.

This question was answered in conjunction with Jon Perlman, M.D.

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Why Is My Hair Falling Out At Age 14? – Hair Loss Information – Balding Blog

what is premature genetic balding…?why is my hair falling out at age 14?

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Assuming you are male, genetic balding can be seen in the early teens, although it is unusual. There are other causes of hair loss as well. I would have your scalp mapped out for miniaturization to make the diagnosis. See a good dermatologist to get this done. If it is early genetic balding, the drug Propecia may help, but clearly you need a good doctor to manage your hair loss.

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Extreme Makeover Plastic Surgery – Hair Loss Information – Balding Blog

I saw you on Extreme Makeover last year. I was wondering if many patients become addicted to plastic surgery once they start doing it?

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I find plastic surgical addiction to be extremely rare in my practice. Most patients are genuinely made to feel better and become happier when “flaws” are improved or fixed.
My Extreme Makeover (ABC Network) experience has shown me how for some, a “makeover” can be more effective in improving self-esteem (and be longer-lasting) than psychotherapy.

This question was answered by Jon Perlman, M.D. Dr. Perlman appeared on Extreme Makeover many, many times.

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Conflicted About My Diagnosis – Hair Loss Information – Balding Blog

A couple of months ago, I began to notice the top of my scalp more prominently after getting out of the shower. Not balding per se, but certainly thinning. I finally went to see a PCP (who took a thorough history and performed the hair pull test) and he felt it was Telogen Effluvium and not MPB, but that we should give it six months and reevaluate then with a blood panel to determine DHT levels before prescribing Proscar.

I’m conflicted about this diagnosis. I did admit I had been feeling some anxiety lately, since my wife and I are expecting our first child in November, and that the stress may be triggering the TE. But on the other side of the debate, my father started experiencing his MPB around my age (my mother’s father left this earth at 90 with a full head of hair, however).

Is this a common approach for a PCP to take?Should I get a second opinion, possibly from a specialist, or should I attempt to be an adult and patiently wait the six months?

Thanks in advance for your time.

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I would recommend that you get a second opinion about your hair loss and in that second opinion, I would get your scalp mapped out for miniaturization, which will show if it is genetic balding as seen in your family line. A hair specialist and dermatologist are in a better position to diagnose your hair loss than your primary care physician, because they see men with the balding process all of the time. Assuming that you do have genetic hair loss, the earlier you get on Propecia, the faster you can save your hair. Time is of the essence and the stress of fatherhood may be a precipitating factor.